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USMLE Step 1: Exam Info

*Information is based off of the USMLE official website. Please visit the USMLE website for additional information, updates, or changes. 

Basic Information

Step 1 assesses the ability to apply basic science concepts to the practice of medicine with a focus on underlying principles of health, disease, and therapy. Step 1 measures basic science knowledge through the interpretation of written and graphic information, as well as problem solving through the application of basic science principles. 

About the Exam

Step 1 is a one-day examination administered in one 8-hour session. The entire examination is approximately 280 multiple choice questions divided into seven 60-minute blocks. Each block contains no more than 40 questions. There is a 15 minute computer tutorial and 45 minutes of break time. 

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Step 1 Scoring

Step 1 is scored on a 3-digit scale with a minimum passing score of 194. 

Step 1 Content

The content on Step 1 covers general principles and individual organ systems. The general breakdown is as follows:

General Principles (12-16%)

Blood and Lymphoreticular/Immune Systems (7-11%)

Behavioral Health and Nervous Systems/Special Senses (9-13%)

Musculoskeletal, Skin and Subcutaneous Tissue (6-10%)

Cardiovascular System (5-9%)

Respiratory and Renal/Urinary Systems (9-13%)

Gastrointestinal System (5-9%)

Reproductive and Endocrine Systems (9-13%)

Multisystem Processes and Disorders (6-10%)

Biostatistics and Epidemiology/Population Health (4-6%)

Social Sciences: Communication and Interpersonal Skills (6-9%)

Step 1 Disciplines

The content on Step 1 (listed above) is tested through various disciplines including: 

Pathology (44-52%)

Physiology (25-35%)

Pharmacology (15-22%)

Biochemistry and Nutrition (14-22%)

Microbiology (10-15%)

Immunology (6-11%)

Gross Anatomy and Embryology (11-15%) 

Histology and Cell Biology (8-13%)

Behavioral Sciences (8-13%)

Genetics (5-9%)

Step 1 Tasks/Competencies

Each test question assesses one of the following:

Medical Knowledge: Applying Foundational Science Concepts (60-70%)

Patient Care: Diagnosis (20-25%)

Patient Care: Management (0% - this is tested on Step 2 CK and Step 3)

Communication and Interpersonal Skills (6-9%)

Practice-Based Learning and Improvement (4-6%)

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